Abstract
Background
Technical modifications and methods for gallbladder dissection to minimize the risk of gallbladder perforation during laparoscopic cholecystectomy (LC) are described. The authors aimed to investigate the effects of gallbladder aspiration during LC on the operative and postoperative course of patients.
Methods
For this study, 200 patients undergoing LC for symptomatic cholelithiasis were randomly divided into two groups. Gallbladders were aspirated before dissection in group A (n = 100), and they were not aspirated in group B (n = 100). Operative and postoperative data on the patients were collected.
Results
The rate of gallbladder perforation was significantly lower in group A than in group B (p = 0.0003). The operative time was significantly shorter in group A (46.70 ± 15.93 min) than in group B (60.75 ± 22.09 min) (p = 0.047). Postoperative complications were more numerous in group B. The hospital stay was significantly longer in group B (1.55 ± 0.81 days) than in group A (1.3 ± 0.5 days; p = 0.004).
Conclusion
The findings demonstrate the advantages of gallbladder aspiration in elective cases.
Similar content being viewed by others
References
Ammori BJ, Larvin M, McMahon MJ (2001) Elective laparoscopic cholecystectomy. Surg Endosc 15: 297–300
Aytac B, Cakar S (2003) The outcome of gallbladder perforation during laparoscopic cholecystectomy. Acta Chir Belg 103: 388–391
Berber E, Engle KL, Garland A, String A, Foroutani A, Pearl JM, Siperstein AE (2001) A critical analysis of intraoperative time utilization in laparoscopic cholecystectomy. Surg Endosc 15: 161–165
Brockmann JG, Kocher T, Senninger NJ, Schurmann GM (2002) Complications due to gallstones lost during laparoscopic cholecystectomy: an analysis of incidence, clinical course, and management. Surg Endosc 16: 1226–1232
Cinel A, Piskin B, Calik A, Kucuktulu U (1997) A method for the closing up of the abdominal trocar wound. Min Invas Ther Allied Technol 6: 139–141
De Simone P, Donadio R, Urbano D (1999) The risk of gallbladder perforation at laparoscopic cholecystectomy. Surg Endosc 13: 1099–1102
Horton M, Florence MG (1998) Unusual abscess patterns following dropped gallstones during laparoscopic cholecystectomy. Am J Surg 8: 113–116
Hui TT, Giurgiu DI, Margulies DR, Takagi S, Iida A, Phillips EH (1999) Iatrogenic gallbladder perforation during laparoscopic cholecystectomy: etiology and sequelae. Am Surg 65: 944–948
Janssen IM, Swank DJ, Boonstra O, Knipscheer BC, Klinkenbijl JH, van Goor H (2003) Randomized clinical trial of ultrasonic versus electrocautery dissection of the gallbladder in laparoscopic cholecystectomy. Br J Surg 90: 799–803
Manukyan MN, Demirkalem P, Gulluoglu BM, Tuney D, Yegen C, Yalin R, Aktan AO (2005) Retained abdominal gallstones during laparoscopic cholecystectomy. Am J Surg 189: 450–452
Martinez C, Lopez A, Nunez J, Gobegui M, Sanz R, Jorgensen T (1999) Changes in hemostasis after laparoscopic cholecystectomy. Surg Endosc 13: 476–479
Meijer DW, Rademaker B, Schlooz S, Bemelman WA, de Wit LT, Bannenberg JJ, Stijnen T, Gouma DF (1997) Laparoscopic cholecystectomy using abdominal wall retraction: hemodynamics and gas exchange: a comparison with conventional pneumoperitoneum. Surg Endosc 11: 645–649
Memon MA, Deeik RK, Maffi TR, Fitzgibbons RJ (1999) The outcome of unretrieved gallstones in the peritoneal cavity during laparoscopic cholecystectomy. Surg Endosc 13: 848–857
Mohiuddin K, Nizami S, Fitzgibbons RJ, Watson P, Memon B, Memon A (2006) Predicting iatrogenic gall bladder perforation during laparoscopic cholecystectomy: a multivariate logistic regression analysis of risk factors. ANZ J Surg 76: 130–132
Naude GP, Morris E, Bongard FS (1998) Laparoscopic cholecystectomy facilitated by hydrodissection. J Laparoendosc Adv Surg Tech A 8: 215–218
Rice DC, Memon MA, Jamison RL Agnessi T, Ilstrup D, Bannon MB, Farnell MB, Grant CS, Sarr MG, Thompson GB, van Heerden JA, Zietlow SP, Donohue JH (1997) Long-term consequences of intraoperative spillage of bile and gall stones during laparoscopic cholecystectomy. J Gastrointest Surg 1:85–91
Sarli L, Pietra N, Costi R, Grattarola M (1999) Gallbladder perforation during laparoscopic cholecystectomy. World J Surg 23: 1186–1190
Tumer AR, Yuksek YN, Yasti AC, Gozalan U, Kama NA (2005) Dropped gallstones during laparoscopic cholecystectomy: the consequences. World J Surg 29: 437–440
Woodfield JC, Rodgers M, Windsor JA (2004) Peritoneal gallstones following laparoscopic cholecystectomy: incidence, complications, and management. Surg Endosc 18: 1200–1207
Yerdel MA, Alacayir I, Malkoc U, Baba F, Erverdi N, Pak I, Turkcapar AG, Aras NJ (1997) The fate of intraperitoneally retained gallstones with different morphologic and microbiologic characteristics: an experimental study. Laparoendosc Adv Surg Tech A 7: 87–94
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Calik, A., Topaloglu, S., Topcu, S. et al. Routine intraoperative aspiration of gallbladder during laparoscopic cholecystectomy. Surg Endosc 21, 1578–1581 (2007). https://doi.org/10.1007/s00464-006-9159-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-006-9159-7